Hydrostatic pressure of the renal pelvis as a radiation-free alternative to fluoroscopic nephrostogram following percutaneous nephrolithotomy.
BMC Urol
; 23(1): 46, 2023 Mar 28.
Article
em En
| MEDLINE
| ID: mdl-36978025
ABSTRACT
BACKGROUND:
We evaluated the hydrostatic pressure of the renal pelvis (RPP) as a radiation-free alternative to fluoroscopic nephrostogram to assess ureteral patency after percutaneous nephrolithotomy (PCNL).METHODS:
Retrospective non-inferiority study analyzing 248 PCNL-patients (86 female (35%) and 162 males (65%)) between 2007 and 2015. Postoperatively, RPP was measured using a central venous pressure manometer in cmH2O. The primary endpoint was to assess RPP depending on the patency of the ureter and the nephrostomy tube removal. Secondary, the upper limit of normal RPP of [Formula see text] 20 cmH2O was assessed as an indicator of an unobstructed patency.RESULTS:
The median procedure duration was 141 min (112-171.5) with a stone free rate of 82% (n = 202). RPP was significantly higher in patients with obstructive nephrostogram with 25.0 mmH2O (21.0-32.0) versus 20.0 mmH2O (16.0-24.0; p < 0.001). The pressure was lower in successful nephrostomy removal with 18 cmH2O (15-21) versus 23 cmH2O (20-29) in the leakage group (p < 0.001). The analysis of a cut-off of [Formula see text] 20 cmH2O showed a sensitivity of 76.9% (95% CI [60.7%; 88.9%]) and a specificity of 61.5% (95% CI [54.6%; 68.2%]). The negative predictive value was 93.4% (95% CI [87.9%; 97.0%]) and the positive predictive value 27.3% (95% CI [19.2%; 36.6%]). The accuracy of the model showed an AUC = 0.795 (95% CI [0.668; 0.862]).CONCLUSION:
The hydrostatic RPP seems to allow a bedside evaluation of ureteral patency after PCNL.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Nefrostomia Percutânea
/
Cálculos Renais
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Nefrolitotomia Percutânea
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
BMC Urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Alemanha